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352007 tn?1372857881

LP Results

No where in sight do I see "IEF" technique on any page of the copied original hospital forms.  It was performed at a couple locations, perhaps more.  

Microbiology was performed at a local hospital near me:


VIRAL CULTURE:   Pending

EPSTEIN-BARR VIRUS:
Direct Exam: 1.  No EBV DNA detected

CSF CULTURE:
GRAM STAIN:  1. Rare WBC's seen
                        2. Nor organisms seen

Culture: No Grow 3 days

CSF FUNGAL CULTURE
Special requests: None
India Ink PR:  Negative for encapsulated yeast
Culture:  No Fungi Isolated 8 days

WBC POLY LYMP MONO OTHER CELLS : CANCELLED EES  (EES = ESSENTIALLY NEGATIVE)

TEST UNITS:

XGSY1: 2.3
XGSY2: 23
XGSY3: 4.3
XGSY4:  957
XGSY5: 35* (neg 9.9 to 3.3)
XOLIGO: 0 bands (Performed at LAB CORP BURLINGTON)
XCWN1: LCNEG1  (Performed at VIROMED LAB)
XCWN2  LCNEG1 (performed at VIROMED LAB)
XMYEL: <2.0 (performed at specialty laboratories)
XCYL1: <0.20
XCLY2: <0.20

LYME CSF IGG/IGM
B. Burgdorferi IGG  <0.20

Performed at Cambridge BIOMED Research GRP

CSF FLD
WEST NILE VIRUS, IGM: Negative

WEST NILE VIRUS, IGG:  Negative

IGG, SYN RATE, CSF IGG, SYN RATE, CSF 3.5*  (Reference range: NEG 9.9 - +3.3)

CSF FLD
MYELIN BASIC PROTEIN <2.0

CSF FLD
(note the results are reported 4/11/11 @ 12:38 PM -- the day I was discharged -- huh?)

OLIGOCLONAL BANDING
OLIGOCLONAL BANDS

"Zero"

(Criteria for positivity:  Four 94) ore more CSF- specific bands have been shown to be most specific with MS using "OUR" method (what method is that?) Am JClin Pathol 120(5): 672-675, 2003).


Ok so what do you all think?


I also have
ANGIO CONV ENZ 55 (WNL)

SJOGREN's SSA SSB anti SS-A and Anti SS-B <0.2


AntidsDNA: 10 (H)

Anti-cardiolipin ab IgM 21.55 (medium positive)

Mycoplasma AB-IGG NEG
Cold Agglutinin NEG
Leionella Ab NEG
Lyme IgG/IgM ELISA Index       NEG


Only thing is that my Phosphorus was 5.4
Mg was WNL
Blood and protein and glucose in my urine. Weak but there.  Gee.  

Ok educate me my intelligent friends!!!

Lisa





15 Responses
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Avatar universal
Hi Lisa.I just wanted to second Mary's opinion that you should get checked out. Positive results in your UA of blood, protein and ketones aren't something to shrug off. Of the tests on the UA strip, those plus the glucose are tests that you don't want to see positive. Like Mary said, blood and protein could indicate damage to the kidneys, and I agree with her that you can lose a lot of kidney function before you become symptomatic. I don't say that to scare you, just reiterating that even trace amounts of these mean something is off.

That said, I do remember from urinalysis class (I'm a med tech, running lab tests is what I do) there are certain things that can interfere with the dipstick test (which is what part of the urinalysis is). Of course, it has been a few years and I didn't remember, so I had to pull out my book and check, because it was bugging me. Yes, I am a nerd, I don't apologize, LOL. This comes courtesy of my urinalysis textbook:

Blood (I have to say I knew this without looking it up, but anyway): the most common false positive is menstrual contamination. So if you gave a sample while either on, or just after your period, this could be a culprit. But if not, this signifies something is going, and still going on. Maybe there is damage from that kidney stone? Definitely worth checking out.

Ketones: Most of the time, this positive result correlates with a positive glucose. When your body can't take in insulin, it breaks down fat to create energy, and the byproduct is ketones. False positives (and this is taken directly from my text book): phthalein dyes, highly pigmented red urine, levodopa (a drug), and medications containing free sulfhydryl groups. This can be be a true positive not only from diabetics, but from loss of carbohydrates from vomiting, inadequate  intake of carbs due to starvation or malabsorption. (also from textbook)

protein: highly buffered alkaline urine can interefere with the test.again, highly pigmented urine, or urine that has quarternary ammonium compounds, antiseptics, and detergents can cause false positive readings. If your urine had a high specific gravity (something they also do with a urinalysis) that could definitely create a false positive. BUT, if it is a real positive, even in trace amounts, that means there is an issue with the kidney. Protein, like glucose, is something the kidneys want to keep in the body, so under normal circumstances, it filters these back into the body.

So, while these positive tests could be false positives, they could also be real issues.I felt moved to write because I do have MS, and my major symptom has been urinary issues. I've learned alot about what can aggravate my neurological symptos. What I do know is that you can have a UTI without any major symptoms.

And, not that you do this, but, I am all about not thinking about a symptom, and pretending it is going away. Been there, done that. While it may give you momentary peace, in the long run it doesn't help. Your pain in your back is concerning, but I do wonder about your "position" when you go to the bathroom. I mean, I have dysynergia,so my bladder and urinary sphinctor don't work together, so I have to time it right to pee, and even when I do, it sometimes doesn't come  out very fast. I lean forward and press on my lower belly, which  helps me. If you do that, that might be why your back hurts.

I hope this helps . I also hope that your doctors can figure out what is going on with you.It ***** to know something is wrong with you and not have the answers. And, even though the answer may stink, at least it will BE an answer and then you can get treatment. Good luck!!

Tiredofbeingnumb(who is numb again, sigh)
Helpful - 0
352007 tn?1372857881
You dont sound preachy at all Mary, you sound like a person who is actually reading what I'm typing and responding with compassion and competent answers.  

MD is aware of the protein and blood in urine the day I gave the UA.  They did not order a C+S that I asked for.  They refused to do a residual (medicine PA covering).   Yes I understand protein and blood no matter how small if it is consistent -- something is up.

I have a Nephrologist that I've seen during the one time I had a 2 cm kidney stone in my renal pelvis for a year. (cant imagine what damage that did floating around) it caused black urine many a times.  Finally it got stuck in my ureter and needed lithrotripsy.  Since then -- which was mmmmmmm 3 years ago, I havent seen him since.

Mary, Im quick to dismiss any diagnosis because I dont want anything more. I've had enough as it is.  I dont want sle nor do I want MS.  No offense to you all....Im hoping there's a logical explanation for all of this.  

Of course I may be going through some denial issues.....who knows.

Thank  you Mary for taking the time to write, giving the link and showing you care <3
Helpful - 0
1045086 tn?1332126422
I believe it is possible for lupus antibodies to cross the BBB.  I know lupus can cause neurological damage that is visible as lesions on MRI of the brain or spine.  You may find some info on the following link helpful.  Be sure to read the FAQ at the end.

http://www.lupus.org/webmodules/webarticlesnet/templates/new_learnaffects.aspx?articleid=2323&zoneid=526

Dr. Quix has told us many times that when we have both symptoms and lesions but the docs say it isn't MS we need to ask them if anything else could cause the symptoms.  Many lesions on MRI are non-specific for the process or disease that is causing them and that is why the doctor who finally diagnoses you correctly will look at ALL your testing as a whole instead of any ONE individual test.

I'm not trying to force a specific diagnosis here but I'm a little surprised you are so quick to dismiss "weak" or "trace" abnormals.  While it is true that not every number outside normal limits is significant, nothing should be dismissed out of hand when diagnosis is elusive but symptoms are persistent.  I get upset when doctors do that, don't you?

Likewise, since you are the only person seeing your UA results who is likely to realize they ROUTINELY show trace amounts of protein and blood, PLEASE mention this to at least one of your doctors.  There is a reason this keeps happening.  What is it?

Did they do a culture on the last specimen?  If you are retaining urine you could easily have a UTI.  It doesn't matter if the UA reported negative bacteria and you don't have normal UTI symptoms.  Infections can be sub-clinical and symptoms can be masked by loss of sensation or go unnoticed when your attention is on more pressing issues.

No UTI?  Get them to check out those kidneys.  Did you tell the doc about the pain you had?  It's reasonable to dismiss one minimally abnormal result.  Habitual spilling of protein and blood into the urine is NOT normal, even in minute amounts.  Random tests may be offering you a bonus warning to take care of a problem BEFORE it gets really serious.  Kidneys are famous for looking good right up until they are ready to fail.

If everything still looks good, wonderful!!

Sorry.  Didn't mean to get preachy or sound ugly.  I know when there is so much going wrong it can seem better to hold back from asking about things that seem trivial.  AND it takes a doc with lots of knowledge and a good dose of curiosity to sort it all out.  Hope you find him soon.

Because I care.
Mary
Helpful - 0
352007 tn?1372857881
PS - Yes, I heard the sarcastic tone and she is well deserving of that one.  She lacks bedside manner.  And here she is a movement disorder specialist and said nothing to me with the myoclonus and right arm tremor, nor told me if there was medication that could decrease its activity so Im not so self conscious.  

Eh, what goes around comes around doesn't it? Karma can be rewarding at times. :D
Helpful - 0
352007 tn?1372857881
Yeah that was a typo the "35" instead of "3.5".  They presented it twice.

The "antidsDNA" is at "10"  and the titer "range" is <10.  So I don't know if that is a false positive or what.

Same with the aCL, it was 21.55 a medium positive.  Though, I have had no history of miscarraiges or blood clotting disorders.  An elevation (weak to me) seems closely related to the Antiphospholipid Antibody Syndrome, which could mimic MS with the neurological symptoms.  I believe SLE and APS are commonly seen together.  However, I ask myself, does this cause Periventricular and cerebellar lesions?  I dont know this but I guess I'll find out on May 4th. Heh.  I can't know everything and I dont.

I've been having nausea (10 months on and off) which obviously inhibits my food intake when it acts up -- which I believe that is the reason why I have ketones in my urine.  The protein and blood is a common occurrence although its a trace amount -- it pops up anytime I have a UA done (which is rarely done but at least once a year).  I only asked for one because I would sit on the toilet and wait 3 minutes for the urine stream to start and then do a dribble.  My middle back was on fire, wasnt sure if it was my kidneys or muscle. I couldn't tell, although felt visceral.

This shall be an interesting ride to the discovery zone.  

Lisa  
Helpful - 0
1045086 tn?1332126422
Sorry I'm late chiming in Lisa.  Parts of my LP testing were also done at Labcorp facilities in Dublin OH and Burlington NC.  The report specifically reported "Oligoclonal Banding testing was performed using Isoelectric Focusing (IEF) and immunoblotting methodology".  At least you can put that question to rest.  You can certainly thank the doc that gave you "all" the results on the 14th (make sure you hear the sarcastic tone there).  Obviously she didn't look them over very carefully as she didn't realize not all the tests were complete.

I'm not sure I can add a lot.  Like Kelly, I'm thinking the high Anti-double strand DNA and medium positive Anti-cardiolipin ab IGM point toward SLE (systemic lupus erythematosus.  I'm thinking 10 is a positive result but different labs have their own way of reporting results so who knows.

The IGG synthesis rate has me confused.  Is it listed twice?  Right under "WEST NILE VIRUS" it is referenced as slightly elevated at 3.5.  Earlier in your post, under "TEST UNITS" there is a XGSY5: 35 (not 3 point 5).  I'm not sure if this is the same IgG synthesis test.  Either way, the result is elevated and indicates an increased permeability of the BBB (blood brain barrier) to plasma proteins.

If you have been on a high protein, low carbohydrate diet you might see both protein and ketones in your urine.  If you haven't been eating well and your body is low on glucose it will break down fat stores for energy.  Ketones are a by-product of that process.  The slightly high serum phosphorus would fit in with that.

You might think about getting a repeat UA done Lisa.  Even though their are only small amounts of blood, protein and ketones in your urine, together they could indicate kidney damage you aren't aware of -- and THAT can be caused by something like LUPUS.

Have you thought about seeing a rheumatologist?  It could be this is the specialist who could best interpret your results.  As we have noted on the forum before, each specialist will read reports with a bias toward diseases in their own specialty.  It IS what they know best!

Like MS, not every test for lupus must be positive for you to have it and it doesn't necessarily look the same in any two people.  I'm not saying you have SLE, just that lupus sometimes presents with neurological aspects that fit your sypmtoms and I think it is worth investigating fully.

Onward toward discovery ---
Mary
Helpful - 0
352007 tn?1372857881
Nevermind, the IEF technique was done and it was completed on 4/19/2011 @ 14:21.  

The only abnormal thing I see is the IgG synthesis rate of 3.5 (neg is 9.9 to +3.3)  So its a weak elevation but indicative of some form of breakdown in the BBB correct?

Helpful - 0
352007 tn?1372857881
Thank you Ren for the link :).  Yes, I noticed it was a weak positive or what they state is in the "equivocal".

I did have ANA drawn multiple times and it's in normal range.  They did ANA reflex, ANARP, Rheumatoid and that too came out WNL.  The primary told me that they ruled out SLE, Rheumatoid, Sarcoidosis and Sjogrens Syndrome.  I can't remember everything at this time, its too early. LOL.

Again thank you Ren for posting.

PS - I wish my myoclonus would stop.  Ive had this before in previous years but it never lasted longer than a day -- even less actually perhaps hours.  I feel like such a freak and look like one.  If a RN who didnt know me in the ER concludes that I was a drug or alcohol addict (although she was wrong), then what do other people think?  I know I shouldn't care what other people think -- but its the abnormality of the movement that embarrasses me. Even the lady at 7/11 who has known me for years said yesterday, "What's wrong with your left leg? Why are you shaking?"   So it is noticeable to the onlooker.  

Helpful - 0
739070 tn?1338603402
Lisa,
Your AntidsDNA is in the "equivocal" range according to Quest Labs and may indicate autoimmune disorders other than lupus. Here's the link:

http://www.seraquest.com/web-storage/pdf_files/anti_dsDNA.pdf

Hope it helps.

Ren
Helpful - 0
352007 tn?1372857881
Hi Jen,

Thanks for taking the time to comment.  Yes, I'm aware there were no bands in the CSF.  

My concern is the "technique they used was not the "gold standard IEF".  I dont know if this makes a difference or not.  The results were available the same day as my LP was done.

@ Kelly -- I'm not too concerned with the gram stain the culture came out negative.

Im not sure how "high" is "10" in the AntidsDNA.  I have to look that up but I have a feeling if it's anything it's slightly elevated and wonder if there could be interfering factors that would make it that way.  I dunno.  My brain is dead right now cause I talked your ear off tonight. LOL.
Helpful - 0
338416 tn?1420045702
I see this:

XOLIGO: 0 bands (Performed at LAB CORP BURLINGTON)

That means that they didn't find any oligoclonal bands in your CSF.
Helpful - 0
Avatar universal
Hi Lisa,

I know you've been anxiously waiting for these results. Are they going to go over them with you, or are they going to be sent over for your neuro appt on the 4th of May?

You're not diabetic are you? - just wondering based on your UA.  

I don't like this - "CSF CULTURE: gram stain: rare wbcs seen" - although, I don't really know what it exactly means. But maybe someone else may know.

With the AntidsDNA: 10 (H) and the Anti-cardiolipin ab IgM 21.55 (medium positive), I wonder if maybe they should focus more testing on Lupus? Have you looked up either of these (knowing you - I'm sure that you have). When I did, Lupus kept popping up.

Hugs, Kelly  

Helpful - 0
352007 tn?1372857881
Oops made a mistake there was ketones (not glucose) in my urine, protein and blood. (trace)

Heh Wobbly -- perhaps someone will know? :)
Helpful - 0
293157 tn?1285873439
I think I'm clueless on this too... sorry can't give you any help.
wobbly
Helpful - 0
352007 tn?1372857881
Oh BTW:

No where on the printed sheets do I see any "serum" for 0-bands. Perhaps they didnt test it because the 0-bands were negative in CSF?

Now I'm clueless.
Helpful - 0
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